Challenges in Diagnosing and Treating Postpartum Blues, Depression and Psychosis

With recent media attention and a growing awareness in popular culture, the appropriate treatment for postpartum depression has taken center stage as a prevalent women‟s health issue. There is little agreement on the definition, existence and treatment of postpartum depression. Contributing to this factor is the lack of research that exists to support which method of counseling best treats postpartum depression. The intent of this paper is to suggest that with increased counseling and counselor involvement postpartum depression can be lessened, decreasing the length and severity of the symptoms without the use of anti-depressants Challenges in Diagnosing and Treating Postpartum Blues, Depression and Psychosis Despite many research studies and a growing awareness throughout the late 20 century, postpartum depression (PPD) has remained an understudied phenomenon. When Texas housewife Andrea Yates murdered her five children in 2001, PPD returned to the forefront of media attention. Yates had a history of PPD and postpartum psychosis; she was eventually found not guilty by reason of insanity (Doherty, 2007). Moreover, when actress Brooke Shields (2005a) published her memoir detailing PPD, fellow actor Tom Cruise publicly condemned her use of antidepressants. Shields fired back by defending her choice and became a vocal advocate for women seeking help with PPD (2005b). These two incidents serve as important reminders that PPD is a prevalent counseling issue, which warrants further study. Prichard (1835) reveals that mood changes in women after childbirth have been observed for hundreds of years, yet this condition has not been adequately addressed by the counseling profession. Albright (1993) states that at least 12% of women suffer from some serious form of PPD. At issue: At what point do the symptoms of depression become critical or dangerous to the life of the mother or the child? PPD affects a significant number of new mothers and has a negative impact on families. PPD has been shown to impair mother-infant bonding (Moehler, Brunner, Wiebel, Reck, & Resh, 2006), family relationships and social functioning (Mauthner, 1998), and even infant development (Ramchandani, Stein, Evans, O‟Connor, 2005; Whitaker, Orzol, & Kahn, 2006). PPD can become disruptive or dangerous to the life of the mother and/or the life of the child. Diagnosing Postpartum Depression There is little agreement on the definition, existence and treatment of postpartum depression. Many factors contribute to the difficulty of diagnosing and treating the problem. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR; American Psychiatric Association [APA], 2000) classifies PPD as major depression single episode or recurrent with postpartum onset. These symptoms are considered the same as those for disorders in non postpartum women. For instance, the DSM formally characterizes PPD as any major depressive, manic, or mixed episode which occurs postpartum. As such, a diagnosis of PPD is determined when one experiences at least five of the nine symptoms listed for major depression at least four